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Speech and Clefts
1. The text you are going to read is entitled “Speech and Clefts”. What do you think it could be about? If you were to deal with the report or the article with the same title, what would you write about?
2. Pay attention to the following terms in the text:
to wonder - интересоваться,
cleft lip - расщелина губы,
cleft palate - расщелина твердого неба,
to affect - влиять,
to indicate - отмечать,
to be related - быть связанным,
hearing loss - потеря слуха,
soft palate - твердое небо,
to breathe in - вдыхать,
to breathe out - выдыхать,
a rate - частота, очередность,
to inhale - вдыхать носом,
air stream - воздушный поток,
larynx - носоглотка,
surgical closure of the palate - операция по закрытию расщелины твердого неба,
surgical intervention - хирургическое вмешательство,
omission of sounds - пропуск звуков,
distortion of sounds - искажение звуков,
substitution of sounds - замена звуков,
to guide through - провести через ч.-л.,
to encourage - хвалить, поощрять,
beforehand - заранее,
intelligibility of speech - осмысление речи,
crucial - важный, необходимый.
II. 1. Find English equivalents in the text:
заметные речевые нарушения;
Use dictionary if necessary.
2. Read the text “Speech and Clefts”.
You are probably wondering if cleft lip and palate will affect baby's ability to speak. Speech is so important in our lives. Everyone does require the ability to speak. If there are no other developmental problems, the child will develop vocabulary and learn to speak just like other children. Research findings, however, indicate that many children with clefts begin talking several months later than children without clefts of the palate. This seems to be in part related to the increased number of ear infections and thus, frequent episodes of hearing loss. Difficulty with speech has been one of the most severe results of cleft palate. Cleft of the lip alone rarely produces a noticeable speech problem, but palatal clefts, especially in the area of the soft palate, may make production of many speech sounds difficult.
Speaking takes place on the air we breathe out. Ordinarily we breathe in and out at a regular rate. When we talk, however, we inhale in a slow, controlled way. The outgoing air stream passes through the larynx, where for the production of sound, a tone is added to the air stream by the vibration of the vocal cords. From the larynx the air is directed into the throat. If the soft palate and the pharyngeal walls (throat walls) are not pulled together, the sound from the throat will enter the nose and the mouth. More than 97% of the speech sounds are produced and formed in the mouth. For these sounds, the soft palate (velum) and the throat walls work together to block off the nose so that the air and sounds will be directed into the mouth.
During the first period, from the time of birth to the time of surgical closure of the palate, the child will produce all sounds through the nose. He or she may develop, in his or her attempt to speak like you, different habits of articulation. Usually he will try to move the back part of the tongue to the pharyngeal wall, in an effort to block the air stream. This attempt may lead to sound omission, substitution and distortion. So instead of "pa-pa", it may sound like "ga-ga", etc.
Early closure of the soft palate is very essential for speech. Cleft lip should be repaired as soon as possible after birth. As to cleft palate repair, opinions are different. Some specialists prefer to operate when the child is eight or ten months old; others prefer to wait until the child is eighteen or twenty- four months of age. As a rule, more than one operation is required to close the cleft completely. Real speech re-education cannot begin until surgical repair has been completed.
Nevertheless, these compensatory articulatory habits are the basis of defective speech, even if the cleft is surgically closed in an ideal way. Speech is usually not established at the earliest until towards the end of the second year of life, but the actual sounds used in speech are acquired much earlier. Therefore you should work closely with the team of speech pathologists who will guide you through all the necessary steps.
The best general advice for parents of children with clefts of the palate is to encourage and stimulate speech just like with any child, but not to expect the same precision and distinctness in the sounds and not to press their child to make the sounds more clearly. They should talk with their child, name things, share experiences and be pleased with their child's attempts to talk. Children with cleft palates, like any other children, do not know they cannot be understood clearly unless they are constantly reminded.
Another question you may have is whether speech therapy will be necessary after repair of the cleft palate. It is impossible to determine this beforehand. The cleft palate team speech pathologist will be able to make this determination more accurately after seeing your child many times. Some children require little therapy, while others may need several months or years and some (luckily very few) may require a special surgical intervention (pharyngoplasty).
The child must, first of all, learn to direct the air stream through the mouth instead of through the nose as has been his or her habit. This ability is crucial for normal sound production. Teaching the consonant sounds to cleft palate children is often more difficult than teaching them to children with speech defects, caused with other reasons. Cleft palate children usually have little conception of how to use the tongue. As the consonant sounds are essential for intelligibility of speech, it is usually wise to teach consonants first even though the vowels are still nasalized.
III. 1. Answer the questions:
Are clefts dangerous for the health of children? Can those children survive without any treatment?
What parts of the articulatory apparatus are affected with the clefts?
What kind of treatment is required for the clefts?
Is surgical intervention necessary or can the children do without it?
When do usually children with the clefts start speaking? Is speech affected with the clefts?
What can parents do to promote their children speaking?
Is the complete cure possible? Or do the clefts leave a mark for the rest of the life?
What speech therapy treatment do the children with the clefts need?
How is the normal process of the production of speech carried out?
How is the process of the production of speech with the cleft carried out?
2. Say whether the following statements are true or false and give the full answer:
a) Clefts are caused with the organic damage of the central nervous system.
b) All clefts must be operated on.
c) The children with the clefts cannot speak.
d) The speech of the children with the clefts is indistinct.
e) The children with the clefts start speaking later than their peers.
f) The nasalization of sounds is typical for the speech of the children with the clefts.
g) The substitution of sounds is very characteristic for the speech of the children with the clefts.
h) The presence of the clefts affects the further development of the child.
i) Clefts are caused with the early traumas.
j) The children with the clefts can attend ordinary mainstream schools.
3. Fill in the blanks with the active words:
a) The speech of the children with the clefts is … and frequently nasalized.
b) Usually we … in and … out at a regular rate.
c) When the walls of the throat are not pulled together the … … goes through the nose and the produced sounds are … .
d) The palates should be closed as… as … .
e) The palates should be closed at the age of … months.
f) The re- education of speech may begin only when the … … is completed.
g) The best general advice for parents is to … and … their child speaking.
h) The … of sounds is very characteristic for the speech of the children with the clefts.
i) It is wise to teach children … first, although … are still indistinct.
j) … are essential for the intelligibility of speech.
4. Continue the sentences:
a) Cleft palate is…
b) Cleft lip is…
c) Clefts affect…
d) The speech of the children with the clefts is…
e) Regularly the air stream…
f) While the child with the cleft is speaking the air stream…
g) The sounds are…
h) The closure of the clefts…
i) The re- education may begin…
j) It may take…
5. Find the synonyms in the text:
-the understanding of speech;
-to be connected;
-the used words;
-to change, to influence;
-clear, correct pronunciation of sounds.
6. Which word in the list is odd?
a) mouth, tongue, throat walls, throat, larynx;
b) substitution, pronunciation, distortion, omission;
c) the closure of the palate, an operative intervention, surgical repair, medical treatment, pharyngoplasty , speech therapy;
d) to inhale, to go through, to breathe in, to breathe out;
e) re- education, speech therapy work, acquiring the ability to speak, an operation;
f) to change, to influence, to affect, to carry out;
g) ear infections, hearing loss, brain traumas, severe damage of the central nervous system.
7. Make up the plan of the text. Here are the titles in the wrong order. Make the order correct.
- the regular speech production;
- surgical intervention;
- the value of speech;
- re-education and speech therapy;
- consonants and vowels;
- the reasons for the clefts;
- sounds omission, distortion and substitution;
- the production of speech with the clefts.
8. Make one sentence with each word in the lists ex I(2) and II(1).
9. Make up five types of questions on the text.
10. Render the text in English.
Расщелина губы и неба должны быть восстановлены как можно ранее после рождения ребенка. Что касается восстановления расщелины неба, то мнения специалистов расходятся: одни считают, что операцию необходимо делать в возрасте 8- 12 месяцев, другие предпочитают подождать возраста 18- 24 месяцев. Как правило, необходимо более чем одно операционное вмешательство для того чтобы полностью закрыть расщелину. Обучение детей правильному произношению может быть начато только после того, как расщелина полностью закрыта.
В первую очередь, ребенок должен научиться направлять воздушный поток через рот, а не через нос, как было ранее, до операции, т.к. стенки твердого неба не удерживали воздух в ротовой полости и он попадал в нос.
Обучение произношению согласных звуков представляет проблему для логопеда, т.к. они имеют смыслоразличительную функцию. Поэтому в коррекционной работе особое внимание уделяется согласным, даже если гласные звуки остаются назализованными.
11. Translate the text “Speech and Clefts” from English into Russian in writing. Pay attention to the examples – they should be in Russian.
The Phonological Approach to Developing Correct Sound Production
I.1. Now you are going to read the text which is entitled “The Phonological Approach to Developing Correct Sound Production”. Judging by the title, what do you think it is about? If you were to deal with the article with the same title, what it would have been about?
2. Pay attention to the following words:
to acquire - приобретать;
to observe - наблюдать;
to involve - вовлекать;
remediation approach - подход к лечению;
criterion - критерий;
accuracy - точность, аккуратность, соответствие;
to look beyond - детально рассмотреть;
to set about - начинать, приступать к ч.-л.;
to identify - узнавать;
a simplification - упрощение;
to drop out - выпадать;
to progress - делать успехи, развиваться;
to focus on smth. - концентрироваться, сосредотачиваться на чем-л.;
to differ in smth. - отличаться чем-л.;
to suppress on smth. - запрещать, скрывать;
to inhabit - наследовать, иметь от рождения;
to delete - удалять, избавляться;
to utilize - использовать;
a clinician - учитель- логопед;
to devise - придумывать, изобретать;
feedback – исправление ошибок, коррекция;
to term - идентифицировать, относить к определенной группе;
to facilitate - облегчать, продвигать;
to incorporate - соединять, объединять;
auditory bombardment - аудио атака;
to enhance - увеличивать, повышать, усиливать;
to shorten - укорачивать, сокращать.
II.1. Find English equivalents to the following Russian words:
-трудности в общении,
-основная задача, цель,
-быть непонятным для других,
-не произносить последний звук слова,
-метод «Простые пары»,
- ограниченное количество звуков,
Use dictionary if necessary.
2. Read the text.
When a child learns to talk, he is actually acquiring skills in four different areas: sound (phonology), vocabulary (semantics), syntax (grammar and morphology) and usage (pragmatics). When any one of these areas is defective, it results in some problems in communication. While all of these areas are important, only one, phonology, will be observed in this article.
The improvement of inadequate phonology has been one of the major tasks for speech-language pathologists. Until 1970s, the typical remediation approach involved teaching sounds, one-by-one to a pre-selected criterion (for example, 90% accuracy). If a child had multiple sound errors, the process usually took years.
In 1970s, speech-language pathologists began revising their approach to sound remediation, especially in the cases of the severely unintelligible child. They started looking beyond the individual sounds and set about identifying patterns of errors called phonological processes.
All children use phonological processes (rule governed simplifications of the adult form) as they learn to talk. These processes normally drop out as the child progresses toward adult speech. When they do not, speech intelligibility remains at a level expected of a younger child. The more phonological processes a child uses, the more unintelligible he is to the rest of the world. According to Hodson and Paden (1991), if a child uses a basic process more than 40% at a time, the process is clinically significant and requires remediation. The phonological approach provides a systematic way of teaching the sounds of the language quickly and efficiently. While both phonological remediation and traditional articulation therapy focus on speech productions that are acceptable and intelligible, they differ in many other areas, such as, goals, acceptance of misproductions, and reinforcement (Khan 1985). Traditional therapy techniques emphasize sounds mastering (with 90% accuracy) in increasingly more complicated contexts (syllables, words, sentences, etc.); whereas the phonological approach focuses on suppressing phonological processes. As a phonological process is inhabited, the sound system becomes more similar to the adult system and the child's speech becomes more intelligible. Any production in which the targeted process has been eliminated is judged to be "correct", even though a sound may be produced incorrectly.
Keeping in mind that the ultimate goal is correct sound production, misproductions in the early phase of treatment are accepted if the targeted phonological process has been eliminated. For example, when a child says "ho" for "home", he has used the phonological process known as deletion of final consonants. Utilizing the phonological approach, the clinician will devise a program that focuses on teaching the child to produce "a sound" at the end of target words. While a specific sound is preferred, any consonant sound produced at the end of the word is accepted. The verbal feedback (reinforcement) a clinician gives after these misproductions is critical. While the misproductions are accepted as correct, only a portion of the child's response is reinforced. For example, if deletion of final consonants is the phonological process being suppressed in the target word "home", a clinician will accept "hone" as correct and say, "Good, you put a sound at the end of the word". A child's production is termed incorrect only if he fails to close the syllable with a final consonant. While there are several different procedures for remediating phonological disorders, only the two most common ones will be presented. Hodson and Paden have introduced the concept of cycles, in which several phonological processes are modified in a specific sequence. Several sounds are used to facilitate the suppression of each phonological process. A cycle may be introduced several times. When the utilized sounds to eliminate the phonological process emerge (50% accurate), the process is said to be suppressed sufficiently and that cycle is dropped and another one is introduced. Hodson and Paden also incorporate the concept of auditory bombardment at the beginning and end of each session. The purpose of auditory bombardment is to enhance the child's ability to discriminate the target sounds auditorally. During the auditory bombardment phase the clinician reads a word list modeling the sounds that are being used in the cycle to suppress the phonological processes. This list is read at a comfortable loudness level and the child is only required to listen to the words. The second treatment method is known as minimal pairs. Minimal pairs consist of two words that differ in pronunciation in only one sound. This method of instruction takes advantage of the semantic confusion which exists because of a phonological process the child is using. For example, if the phonological process to be suppressed is deletion of final consonants, one of the minimal pairs presented in treatment could be "bee" and "beep". Utilizing the minimal pairs method, situations are devised in the treatment session to capitalize on the semantic confusion that exists when a child pronounces both words as "bee". The child must revise his productions until his clinician is no longer confused between the two words.
Whereas the traditional articulation approach is effective with children who demonstrate difficulty with a limited number of sounds, the phonological approach is better suited for use with the children who are severely unintelligible due to the difficulty with numerous sounds. Using the phonological treatment approach with severely unintelligible children shortens the length of time necessary to improve their sound systems. And in today's time-pressured world that is important.
III.1.Answer the questions:
What is phonological approach?
When did it appear?
Who was the founder of this approach?
What other approaches do you know?
What children is this approach applied to?
What are the main goals of this approach?
What features can the speech of the children with phonological approach be characterized with?
What are the main advantages of this approach?
Can this approach be accompanied with any other method?
Which of the listed above methods is more effective?
How is the process of the evaluation carried out by the clinician?
How is phonology connected with other language units?
2. Say whether the following statements are true or false:
a) The use of phonological process approach is a part of speech therapy correction work.
b) Phonology as well as vocabulary effect communication.
c) The children with speech defects cannot get rid of the defects without the phonological process approach.
d) The phonological approach is the only method used in speech therapy practice.
e) Speech–language pathologists deal with the defects of speech and its improvement.
f) All children learn to speak in the same manner and way.
g) The method of minimal pairs is a part of speech correction work.
h) The method of auditory bombardment is the most influential as it teaches the children to say between the words.
i) The speech therapist only observes the sound correctional process and the clinician really works on the elimination of the respective defects.
j) The cycles first presented by Hodson and Paden are not used nowadays.
k) The sound correctional process takes years.
l) Speech is very important in our life.
3. Continue the sentences:
a) There are several approaches for speech sound correction …
b) The phonological approach is …
c) It is applied to …
d) The speech therapist and the clinician …
e) Phonology, vocabulary, morphology and grammar …
f) Auditory bombardment is …
g) The purpose of auditory bombardment is …
h) Minimal pairs are used …
i) The evaluation of progress …
j) The ultimate goal of speech sound correction is …
4. Fill in the blanks with the words from the text:
a) When a child learns to talk, he is actually… … in four different areas: sound (phonology), vocabulary (semantics), syntax (grammar and morphology) and usage (pragmatics).
b) When any one of these areas is …, it results in some problems in communication. While all of these areas are important, only one, phonology, will be observed in this article.
c) In 1970s, speech-language pathologists began revising their approach to … …, especially in the cases of the severely unintelligible child.
d) They started … … the individual sounds and set about identifying patterns of errors called phonological processes.
e) All children use … … (rule governed simplifications of the adult form) as they learn to talk.
f) These processes normally… … as the child progresses toward adult speech.
g) If a child uses a basic process more than 40% at a time, the process is clinically significant and requires ….
h) While both phonological remediation and traditional articulation therapy … … speech productions that are acceptable and intelligible, they … in many other areas, such as, goals, acceptance of misproductions, and reinforcement.
i) Traditional therapy techniques emphasize sounds mastering (with 90% accuracy) in increasingly more complicated contexts (syllables, words, sentences, etc.); whereas the … … focuses on suppressing phonological processes.
j) As a phonological process is …, the sound system becomes more similar to the adult system and the child's speech becomes more intelligible.
k) Any production in which the targeted process has been … is judged to be "correct", even though a sound may be produced incorrectly.
5. Give synonyms from the text:
-to be not alike.
6. Make up the plan of the text. Here are the titles in the wrong order. Make the order correct:
-the evaluation of the process of speech sound correction;
-the components of speech;
-the value of speech;
-the ultimate goal of speech sound correction;
7. Make up one sentence with each word from ex I(2) and II(1).
8. Make up five types of questions on the text.
9. Render the text in English:
В процессе овладения речью ребенок осваивает не только лексику и грамматику родного языка, но и фонетику, которая имеет огромное значение для полноценного общения в современном мире. В семидесятые годы ХХ-ого века логопеды Хадсон и Паден предложили новый подход к лечению дефектов речи, основанный на врожденной способности детей к подражанию, которая состоит из 2-х основных циклов: а) обратить внимание ребенка на неверное произношение и предложить повторить за учителем несколько слов, которые отличаются лишь одной буквой (это упражнение получило название «пары»); б) предложить ребенку повторить за учителем непохожие друг на друга слова, обращая внимание на правильное произнесение части слова, в которой встречаются типичные ошибки (это упражнение получило название « аудио атака»). В современной логопедической науке данный метод широко используется в модифицированном виде и дает положительные результаты даже в самых сложных случаях нарушений речи.
10. Make the written translation of the text. Pay special attention to the examples – they should be in Russian.
11. Make a report on some other approaches of speech therapy.
I.1. The text you are going to read is dedicated to Stuttering. If you were to deal with such
topic, what would you speak about?
2. Pay attention to the following terms used in the text:
to disrupt - предостерегать;
to volunteer - проявлять инициативу;
fluency - беглость;
to encompass - включать в себя, иметь ввиду, подразумевать большую группу людей;
barely perceptible impediments - легко обнаруживаемые, очевидные недостатки;
impact - внутреннее содержание;
to enunciate - четко и внятно разговаривать, произносить звуки;
stigmatized disability - считать определенный тип поведения неправильным и относится к этому предвзято;
to increase - увеличивать;
a device - средство;
covert - секрет;
to whisper - шептать;
to embarrass - заставить понервничать, пристыдить на людях;
shame - стыд;
to frustrate - раздражать, предотвращая к.-л. поступок;
fear - страх;
anger - злость;
guilt - чувство вины, вина;
to take a breath - глубоко вздохнуть, передохнуть, взять паузу;
to blink - мигать глазами;
tumor - опухоль;
a stroke - кровоизлияние в мозг, инсульт;
to tend - стремиться, иметь тенденцию;
bereavement - потеря близкого человека;
to contribute to smth. - вносить вклад, помогать;
concomitant speech - одновременная речь, в одно и то же вр.;
to confirm - признавать вину, ошибку;
sibling - наличие или рождение родных братьев или сестер;
feedback - исправление ошибок;
a jaw - челюсть;
the core behaviors - основное поведение;
medications - медицинские препараты, лекарства;
to achieve - достигать;
to cure - излечивать;
II. 1. Find the following English equivalents in the text:
-неконтролируемые повторения звуков;
-генетический и нейрофизиологический фактор;
-говорить одновременно с др.людьми, хором;
-значительное негативное влияние на мышление и качество жизни;
- передозировка лекарственными средствами;
-растягивать гласные и согласные звуки;
- препараты для снижения давления;
-перспектива на выздоровление;
Use dictionary if necessary.
2. Read the text:
Stuttering, also known as stammering in the United Kingdom, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases, and involuntary silent pauses or blocks in which the stutterer is unable to produce sounds. 'Verbal non- fluency ' is the accepted term for such speech disorders. The term is most commonly associated with involuntary sound repetition, but it also encompasses the abnormal hesitation or pausing before speech, referred to by stutterers as blocks, and the prolongation of certain sounds, usually vowels and semi-vowels. The term "stuttering", as popularly used, covers a wide spectrum of severity: it may encompass individuals with barely perceptible impediments, for whom the disorder is largely cosmetic, as well as others with extremely severe symptoms, for whom the problem can effectively prevent most oral communication. The impact of stuttering on a person's functioning and emotional state can be severe. Much of this goes unnoticed by the listener, and may include fears of having to enunciate specific vowels or consonants, fears of being caught stuttering in social situations, self-imposed isolation, anxiety, stress, shame, or a feeling of "loss of control" during speech.
Stuttering is generally not a problem with the physical production of speech sounds or putting thoughts into words. Despite popular perceptions to the contrary, stuttering does not affect and has no bearing on intelligence. Apart from their speech impediment, people who stutter may well be 'normal' in the clinical sense of the term. Anxiety, low self-esteem, nervousness, and stress therefore do not cause stuttering, although they are very often the result of living with a highly stigmatized disability and, in turn, exacerbate the problem.
The disorder is also variable, which means that in certain situations, such as talking on the telephone, the stuttering might be more severe or less, depending on the anxiety level connected with that activity. Although the exact etiology of stuttering is unknown, both genetics and neurophysiology are thought to contribute. Although there are many treatments and speech therapy techniques available that may help increase fluency in some stutterers, there is essentially no "cure" for the disorder at present. Developmental stuttering originates when a child is learning to speak and develops as the child matures into adulthood. Primary stuttering behaviors are the overt, observable signs of speech fluency breakdown, including repeating sounds, syllables, words or phrases, silent blocks and prolongation of sounds. Secondary stuttering behaviors are unrelated to speech production and are learned behaviors which become linked to the primary behaviors. They include escape behaviors, in which a stutterer attempts to terminate a moment of stuttering. Examples might be physical movements such as sudden loss of eye contact, eye-blinking, head jerks, hand tapping, interjected "starter" sounds and words, such as "um," "ah," "you know". In many cases, these devices work at first and are becoming a habit that is subsequently difficult to break.
Secondary behaviors also refer to the use of avoidance strategies such avoiding specific words, people or situations that the person finds difficult. Some stutterers successfully use extensive avoidance of situations and words to maintain fluency and may have little or no evidence of primary stuttering behaviors. Such covert stutterers may have high levels of anxiety, and extreme fear of even the mildest disfluency.
The severity of a stutter is often not constant increased stuttering is reported. Stuttering may have a significant negative cognitive and affective impact on the stutterer. Feelings of embarrassment, shame, frustration, fear, anger, and guilt are frequent in stutterers, and may actually increase tension and effort, leading to increased stuttering. With time, continued exposure to difficult speaking experiences may crystallize into a negative self-concept and self-image. A stutterer may project his or her attitudes onto others, believing that they think he is nervous or stupid. Such negative feelings and attitudes may need to be a major focus of a treatment program.
Stuttering is typically a developmental disorder beginning in early childhood and continuing into adulthood in at least 20% of affected children. The mean onset of stuttering is 30 months. Although there is variability, early stuttering behaviors usually consist of word or syllable even for severe stutterers. Stutterers commonly report dramatically increased fluency when talking in unison with another speaker, copying another's speech, whispering, singing, and acting or when talking to pets, young children, or themselves. Other situations, such as public speaking and speaking on the telephone are often greatly feared by stutterers, and repetitions, and secondary behaviors such as tension, avoidance or escape behaviors are absent. Most young children are unaware of the interruptions in their speech. With early stutterers, disfluency may be episodic, and periods of stuttering are followed by periods of relative fluency. Recommendations to slow down, take a breath, say it again, etc may increase the child’s anxiety and fear, leading to more difficulties with speaking and, in the “cycle of stuttering” to ever yet more fear, anxiety and expectation of stuttering. With time secondary stuttering including escape behaviors such eye blinking, lip movements, etc. may be used, as well as fear and avoidance of sounds, words, people, or speaking situations. Eventually, many become fully aware of their disorder and begin to identify themselves as "stutterers." With this may come deeper frustration, embarrassment and shame. Other, rarer, patterns of stuttering development have been described, including sudden onset with the child being unable to speak, despite attempts to do so. The child usually blocks silently of the first sound of a sentence, and shows high levels of awareness and frustration. Another variety also begins suddenly with frequent word and phrase repetition, and do not develop secondary stuttering behaviors. In rare cases, stuttering may be acquired in adulthood as the result of a neurological event such as a head injury, tumor, stroke or drug abuse/misuse. The stuttering has different characteristics from its developmental equivalent: it tends to be limited to part-word or sound repetitions, and is associated with a relative lack of anxiety and secondary stuttering behaviors. Techniques such as altered auditory feedback which may promote fluency in stutterers with the developmental condition are not effective with the acquired type. Psychogenic stuttering may also arise after a traumatic experience such as bereavement, the breakup of a relationship or as the psychological reaction to physical trauma. Its symptoms tend to be homogeneous: the stuttering is of sudden onset and associated with a significant event, it is constant and uninfluenced by different speaking situations, and there is little awareness or concern shown by the speaker.
No single, exclusive cause of developmental stuttering is known. A variety of hypotheses and theories suggest multiple factors contributing to stuttering. Among these is the strong evidence that stuttering has a genetic basis. However, twin and adoption studies suggest that genetic factors interact with environmental factors for stuttering to occur; and forty to seventy percent of stutterers have no family history of the disorder. There is evidence that stuttering is more common in children who also have concomitant speech, language, learning or motor difficulties.
In some stutterers, congenital factors may play a role. These may include physical trauma at or around birth, including cerebral palsy, retardation, or stressful situations, such as the birth of a sibling, moving, or a sudden growth in linguistic ability.
There is clear empirical evidence for structural and functional differences in the brains of stutterers. Research is complicated somewhat by the possibility that such differences could be the consequences of stuttering rather than a cause, but recent research on older children confirms structural differences thereby giving strength to the argument that at least some of the differences are not a consequence of stuttering.
Auditory processing deficits have also been proposed as a cause of stuttering. Stuttering is less prevalent in deaf and hard of hearing individuals, and stuttering may be improved when auditory feedback is altered, such as masking, delayed auditory feedback (DAF), or frequency altered feedback. There is some evidence that the functional organization of the auditory cortex may be different in stutterers.
There is evidence of differences in linguistic processing between stutterers and non-stutterers. Brain scans of adult stutterers have found increased activation of the right hemisphere, which is associated with emotions, than in the left hemisphere, which is associated with speech. In addition reduced activation in the left auditory cortex has been observed.
The capacities and demands model has been proposed to account for the heterogeneity of the disorder. In this approach, speech performance varies depending on the capacity that the individual has for producing fluent speech, and the demands placed upon the person by the speaking situation. In stuttering, the severity of the disorder is seen as likely to increase when demands placed on the person's speech and language system is exceeded by their capacity to deal with these pressures. Fluency shaping therapy, also known as "speak more fluently", "prolonged speech" or "connected speech", trains stutterers to speak fluently by controlling their breathing, phonation, and articulation (lips, jaw, and tongue). It is based on operant conditioning techniques.
Stutterers are trained to reduce their speaking rate by stretching vowels and consonants, and using other fluency techniques such as continuous airflow and soft speech contacts. The result is very slow, monotonic, but fluent speech used only in the speech clinic. After the stutterer masters these fluency skills, the speaking rate and intonation are increased gradually. This more normal-sounding, fluent speech is then transferred to daily life outside the speech clinic, though lack of speech naturalness at the end of treatment remains a frequent criticism. Fluency shaping approaches are often taught in intensive group therapy programs, which may take two to three weeks to complete, but more recently the Camperdown program, using a much shorter schedule, has been shown to be effective. The goal of stuttering modification therapy is not to eliminate stuttering but to modify it so that stuttering is easier and less effortful. The rationale is that since fear and anxiety causes increased stuttering, using easier stuttering and with less fear and avoidance, stuttering will decrease. The most widely known approach was published in 1973 and is also known as block modification therapy.
In the first stage, called identification, the stutterer and clinician identify the core behaviors, secondary behaviors, and feelings and attitudes that characterize the stuttering.
In the second stage, called desensitization, the stutterer works to reduce fear and anxiety by freezing stuttering behaviors, confronting difficult sounds, words and situations, and intentionally stuttering ("voluntary stuttering").
In the third stage, called modification, the stutterer learns "easy stuttering." This is done by "cancellations" (stopping in a disfluency, pausing a few moments, and saying the word again); "pull-outs," or pulling out of a disfluency into fluent speech; and "preparatory sets," or looking ahead for words one may stutter on, and using "easy stuttering" on those words.
In the fourth stage, called stabilization, the stutterer prepares practice assignments, makes preparatory sets and pull-outs automatic, and changes their self-concept from being a person who stutters to being a person who speaks fluently most of the time but who occasionally stutters mildly.
Altered auditory feedback, so that stutterers hear their voice differently, have been used for over 50 years in the treatment of stuttering. Altered auditory feedback effect can be produced by speaking in chorus with another person, by providing blocking out the stutterer's voice while talking (masking), by delaying the stutterer's voice slightly (delayed auditory feedback) and/or by altering the frequency of the feedback (frequency altered feedback). Studies of these techniques have had mixed results, with some stutterers showing substantial reductions in stuttering, while others improved only slightly or not at all. In a 2006 review of the efficacy of stuttering treatments, none of the studies on altered auditory feedback met the criteria for experimental quality, such as the presence of control groups.
The effectiveness of pharmacological agents, such as in the treatment of stuttering has been evaluated in studies involving both adults and children. A comprehensive review of pharmacological treatments of stuttering in 2006 concluded that few of the drug trials were methodologically sound.
Among preschoolers, the prognosis for recovery is good. Based on research, about 65% of preschoolers who stutter recover spontaneously in the first two years of stuttering, and about 74% recover by their early teens. In particular, girls seem to recover well. For others, early intervention is effective in helping the child achieve normal fluency.
Once stuttering has become established, and the child has developed secondary behaviors, the prognosis is more guarded, and only 18% of children who stutter after five years recover spontaneously. However, with treatment young children may be left with little evidence of stuttering. With adult stutterers, there is no known cure, though they may make partial recovery with intervention. Stutterers often learn to stutter less severely and be less affected emotionally, though others may make no progress with therapy. The lifetime prevalence, or the proportion of individuals expected to stutter at one time in their lives, is about 5%, and overall males are affected two to five times more often than females. Most stuttering begins in early childhood and according studies suggest 2.5% of children under the age of 5 stutter. The sex ratio appears to widen as children grow: among preschoolers, boys who stutter outnumber girls who stutter about two to one, or less but widens to three to one at first grade and five to one at fifth grade, due to higher recovery rates in girls. Stuttering occurs in all cultures and races, and at similar rates. A US-based study indicated that there were no racial or ethnic differences in the incidence of stuttering in preschool children.
III. 1. Answer the questions:
a) What is stuttering?
b) What is another name of that speech disorder?
c) What is the impact of stuttering?
d) Do boys stutter more than girls?
e) Do adults stutter?
f) What are the peculiarities of grown-ups` stuttering?
g) Is there a cure for stuttering?
h) What is speech therapy for stuttering?
i) What are the chances for recovery in the cases of stuttering?
2. Say whether the following statements are true or false:
a) Stuttering is verbal non- fluency.
b) Stuttering is generally not a problem with putting thoughts into words.
c) People who stutter are 'normal' in the clinical sense of the term.
d) There is no cure for the disorder at present.
e) The exact etiology of stuttering is unknown.
g) Embarrassment, shame, frustration, fear, anger, and guilt may produce stuttering blocks.
h) Stuttering is more common in children.
i) Stuttering has a genetic basis.
j) The goal of stuttering modification therapy is not to eliminate stuttering but to modify it so that stuttering is easier and less effortful.
3. Continue the sentences:
a) Stuttering is…
b) It maybe…
c) The reasons for stuttering are…
d)The severity of stuttering…
e) The speech therapy…
f) Boys stutter…
g) Adults stutter…
h) The general goal of speech therapy…
4. Fill in the blanks with the words from the text:
… also known as stammering in the United Kingdom, is a…in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases, and involuntary silent pauses or … in which the stutterer is unable to produce sounds. '…… ' is the accepted term for such speech disorders. The term is most commonly associated with involuntary sound repetition, but it also … the abnormal hesitation or pausing before speech, referred to by stutterers as…, and the prolongation of certain sounds, usually vowels and semi-vowels. The term …, as popularly used, covers a wide spectrum of severity: it may … individuals with barely perceptible …, for whom the disorder is largely cosmetic, as well as others with extremely severe symptoms, for whom the problem can effectively prevent most oral communication. The… of on a person's functioning and emotional state can be severe. Much of this goes unnoticed by the listener, and may include … of having to enunciate specific vowels or consonants, … of being caught … in social situations, self-imposed isolation, anxiety, stress, shame, or a feeling of "loss of control" during speech. … is generally not a problem with the physical production of speech sounds or putting thoughts into words. Despite popular perceptions to the contrary,…does not affect and has no bearing on intelligence. Apart from their speech …, people who … may well be 'normal' in the clinical sense of the term. Anxiety, low self-esteem, nervousness, and stress therefore do not cause …, although they are very often the result of living with a highly stigmatized disability and, in turn, exacerbate the problem. The… is also variable, which means that in certain situations, such as talking on the telephone, the … might be more severe or less, depending on the anxiety level connected with that activity. Although the exact etiology of … is unknown, both genetics and neurophysiology are thought to contribute. Although there are many … and speech therapy techniques available that may help increase fluency in some …, there is essentially no "cure" for the disorder at present.
5. Give synonyms from the text:
-to correct the mistakes;
-to speak simultaneously;
6. Which word in the list is odd?
a) Stuttering, stammering, speech disorder, verbal non- fluency;
b) operant conditioning techniques, stuttering modification therapy, the Camperdown program, intensive group therapy programs, involuntary sound repetition;
c) anxiety, low self-esteem, nervousness, stress, highly stigmatized disability;
d) neurophysiology, genetics, etiology, blocks;
e) sounds, syllables, words, phrases, silent pauses, blocks, vowels and semi-vowels.
7. Make up the plan of the text. Here are the titles in the wrong order. Make the order correct:
-speech therapy stuttering techniques;
-the definition of stuttering;
-the variability of stuttering;
-the levels and stages of stuttering development;
-the general goal of speech therapy for stuttering;
-the causes and reasons for stuttering.
8. Make up one sentence with each word from ex I( 2) and II(1).
9. Make up five types of questions on the text.
10. Render the text in English:
Заикание может негативно влиять на эффективность обучения в целом и на мыслительную деятельность в частности. Чувства неуверенности в себе, стыда, растерянности, страха или вины часто сопутствуют приступам заикания и могут привести к их более частым проявлениям. Чем чаще больной сталкивается с затруднениями в речи, тем сильнее формируется в сознании негативный собственный образ. Больной так же может проецировать свое негативное отношение на окружающих, полагая, что его считают нервным или глупым. Проявления таких негативных чувств должны быть основным аспектом лечения и коррекционной программы.
Заикание является типичным заболеванием при развитии ребенка, которое встречается в раннем детстве и в 20% случаев встречается у взрослых. Период развития заболевания составляет примерно 30 месяцев. Встречаются разные формы осложненности, но, как правило, первыми признаками являются повторения слогов или слов, в то время как напряженность, желание избежать ситуации говорения отсутствуют.
Большинство детей не обращают внимания на то, что их перебивают. У них приступы заикания могут быть эпизодическими, после которых наблюдается нормально интонированная речь. К сожалению, советы взрослых не торопиться, передохнуть, повторить, начать сначала могут привести к тому, что чувства страха и нервозности только усилятся. Это, в свою очередь, может вызвать еще большие страхи, которые могут привести к еще большим проблемам в ожидании приступа заикания. С течением времени заикание может прогрессировать и появляются вторичные признаки, такие как ассиметричные движения парных мышц лица, страх проявляется в желании избежать слов, на которых больной обычно «спотыкается», ситуаций говорения, а так же людей, с которыми могут быть связаны неприятные моменты.
11. Make the written translation of the text. Pay special attention to the examples – they should be in Russian.
12. Read the text and make a report about some other approaches onto stuttering.
THE HISTORY OF STUTTERING
For centuries stuttering has featured prominently in society at large. Because of the unusual-sounding speech that is produced, as well as the behaviors and attitudes that accompany a stutter, stuttering has been a subject of scientific interest, curiosity, discrimination, and ridicule. Stuttering was, and essentially still is, a riddle with a long history of interest and speculation into its causes and cures. Stutterers can be traced back centuries to the likes of Demosthenes, who tried to control his disfluency by speaking with pebbles in his mouth. The Talmud interprets Bible passages to indicate Moses was also a stutterer, and that placing a burning coal in his mouth had caused him to be "slow and hesitant of speech". Galen's humoral theories remained influential in Europe into the Middle Ages and beyond. In this theory, stuttering was attributed to imbalances of the four bodily humors: yellow bile, blood, black bile, and phlegm. Hieronymus Mercurialis, writing in the sixteenth century, proposed methods to redress the imbalance including changes in diet, reduced lovemaking (in men only), and purging. Believing that fear aggravated stuttering, he suggested techniques to overcome this. Humoral manipulation continued to be a dominant treatment for stuttering until the eighteenth century. Partly due to a perceived lack of intelligence because of his stutter, the man who became the Roman Emperor Claudius was initially shunned from the public eye and excluded from public office.
In eighteenth and nineteenth century Europe or around there, surgical interventions for stuttering were recommended, including cutting the tongue with scissors, removing a triangular wedge from the posterior tongue, cutting nerves, and neck and lip muscles. Others recommended shortening the uvula or removing the tonsils. All were abandoned due to the high danger of bleeding to death and their failure to stop stuttering. Less drastically, Jean Marc Gaspard Itard placed a small forked golden plate under the tongue in order to support "weak" muscles. Italian pathologist Giovanni Morgagni attributed stuttering to deviations in the hyoid bone, a conclusion he came to via autopsy. Blessed Notker of St. Gall, called Balbulus and described by his biographer as being "delicate of body but not of mind, stuttering of tongue but not of intellect, pushing boldly forward in things Divine," was invoked against stammering. Other famous Englishmen who stammered were King George VI and Prime Minister Winston Churchill, who led the UK through World War II. George VI went through years of speech therapy for his stammer. Churchill claimed, perhaps not directly discussing himself, "Sometimes a slight and not unpleasing stammer or impediment has been of some assistance in securing the attention of the audience...". However, those who knew Churchill and commented on his stutter believed that it was or had been a significant problem for him. His secretary Phyllis Moir in her 1941 book 'I was Winston Churchill's Private Secretary' commented that 'Winston Churchill was born and grew up with a stutter'. Moir writes also about one incident 'It’s s s simply s s splendid” he stuttered, as he always did when excited.’ Louis J. Alber. who helped to arrange a lecture tour of the United States wrote in Volume 55 of The American Mercury (1942) ‘Churchill struggled to express his feelings but his stutter caught him in the throat and his face turned purple' and ‘Born with a stutter and a lisp, both caused in large measure by a defect in his palate, Churchill was at first seriously hampered in his public speaking. It is characteristic of the man’s perseverance that, despite his staggering handicap, he made himself one of the greatest orators of our time.
For centuries "cures" such as consistently drinking water from a snail shell for the rest of one's life, "hitting a stutterer in the face when the weather is cloudy", strengthening the tongue as a muscle, and various herbal remedies were used. Similarly, in the past people have subscribed to theories about the causes of stuttering which today are considered odd. Proposed causes of stuttering have included tickling an infant too much, eating improperly during breastfeeding, allowing an infant to look in the mirror, cutting a child's hair before the child spoke his or her first words, having too small a tongue, or the "work of the devil." Jazz and Euro Dance musician Scatman John wrote the song "Scatman (Ski Ba Bop Ba Dop Bop)" to help children who stutter overcome adversity. Born John Paul Larkin, Scatman spoke with a stutter himself and won the American Speech-Language-Hearing Association's Annie Glenn Award for outstanding service to the stuttering community. Fiction character Albert Arkwright from British sitcom Open All Hours, stammered and much of the series' humor revolved around this.